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HEALTH CARE POLICY Seidman Speaker Sees Health Care Spending Likely to Keep Rising The presentation of the third annual Marshall J. Seidman Lecture in Health Policy on April 22 gave perspective to what is becoming a national dialogue on health care reform in the early stages of the 2004 Presidential campaign. Seidman speaker Gail Wilensky, a senior fellow at Project HOPE and an economist and longtime government adviser, outlined the recent history of health care spending and projected future trends. As a percentage of gross domestic product (GDP), spending on health care has generally undergone a steady increase since 1960 and is estimated to reach 17 percent or higher by 2011. The exception is the decade of the '90s, she said, when this figure was fairly firm, varying between 12.0 and 13.3 percent. Gail Wilensky, who gave the third annual Seidman lecture, talks with Marshall Seidman, whose gift created the lecture program in 2000. (Photo by Jeff Thiebauth) Spending now is on the rise again because the public and private pressures that had contained it have dissipated. Medicare spending is up, and costs are rising particularly for hospital services and prescription drugs. Since there is no sign of a slowdown, Wilensky said, "Could we at least spend smarter?" Her suggested improvements are better information on what works and when in health care delivery, widely available data on which providers offer high quality, and more choices and incentives for consumers and patients. In the question-and-answer period, Lucian Leape, HSPH adjunct professor of health policy, asked whether the upcoming Presidential election might spur some change at the federal level. Wilensky was dubious: "I believe it is going to be very difficult to make significant changes in Medicare as long as the Congress is so evenly divided." Wilensky's lecture, titled "1991 Revisited--Can We Be Smarter the Second Time Around?", was introduced by Barbara McNeil, chair of the Department of Health Care Policy, and Joseph Martin, dean of the Faculty of Medicine. Also attending was Marshall Seidman, who established the lectureship in 2000 along with the Marshall J. Seidman Program for Medical Economics in the Department of Health Care Policy. --Robert Neal